25.1.5
Constipation
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 25, Palliative Care.
Clinical Description
Common causes (see relevant chapter for details)
Cancer, drugs (especially opiates, ondansetron), debility
Non-pharmacological
- Encourage fluid intake and eating papaya, ambulation/gentle exercise where possible, manual evacuation may be needed for faecal impaction
Pharmacological
- osmotic laxatives - lactulose? liquid paraffin (dose?)
- stimulant laxatives - Biscodyl 10mg nocte
- lubricant - Glycerine suppository 1, 24 hourly (not long term)
Complications and Referral Criteria
- Faecal impaction is very distressing and painful which may require referral for further management and/or manual evacuation where indicated.
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